Diarrhea

Article Translations: (Spanish) (Hmong)

What is diarrhea?

Diarrhea is a sudden increase in the number and looseness of stools (bowel movements).  It can vary from several loose or mushy stools to many watery stools.  One or two loose stools is not diarrhea, and no treatment is needed.

Diarrhea is often caused by a viral infection or eating food that does not “agree” with the stomach (too spicy, too rich, or new foods).  If the diarrhea is caused by a bacteria, parasite, or specific virus, see the education sheet, “Diarrhea reference chart.”

The main danger of diarrhea is dehydration (becoming “dried out”).  The younger the child, the more quickly this can happen.  If your baby is younger than 3 months, call your clinic for advice before beginning home treatment.  If your child shows signs of dehydration call the doctor.

Signs of mild to moderate dehydration:

• no urine (or wet diaper) for 8 hours
• dry lips
• the inside of the mouth is dry or sticky

Signs of severe dehydration:

• no tears when crying
• the inside of the mouth is very dry (no saliva)
• eyes seem sunken
• weight loss
• listless (has little energy)
• hard to awaken
• confused
• weakness (hard to sit up or walk, floppy)

How should I care for my child?

The goal of treatment is to prevent dehydration by giving liquids to replace fluids that are lost in the diarrhea. This is especially important if vomiting is also present. If your child is vomiting, follow the instructions in the education sheet, “Vomiting”, before treating for diarrhea.

If there is no vomiting, follow these instructions. You cannot cure the diarrhea with diet changes but you can decrease symptoms and discomfort.

Start treatment after your child has 4 or more loose stools in 24 hours. It may take several days for stools to be normal again.  Viral diarrhea often lasts 5 to 9 days but diarrhea stools should be less frequent and smaller in size with treatment.

To help restore the normal healthy bacteria in the bowel, you can give lactobacillus GG, (such as Culturelle®) available over the counter at the drug store, 1 capsule twice a day sprinkled in food. Other types of lactobacillus have not been shown to be as helpful.

Infants (up to 12 months)

• Breastfeed or give formula as much as your baby wants.
• If the diarrhea is not improving or is watery, offer an oral rehydration solution (Pedialyte® or another brand) between feedings. Do not give plain water.
• It may not help to change formulas, but your doctor or nurse practitioner may suggest a trial.
• If your baby is on solid foods, you may continue to give them as usual.

Children older than 1 year

• Encourage plenty of liquids. Avoid fruit juice and sugary drinks which increase diarrhea.
• Continue a regular diet, but avoid fatty foods. Some children do better eating these foods:
  • starchy foods, such as cereal, pasta, potatoes, rice, toast
  • applesauce, bananas
  • cooked carrots
  • gelatin (Jell-O^® or other brands)
  • yogurt

How can I prevent the spread of diarrhea?

Diarrhea spreads to others very easily by contact with the hands.  Make sure everyone in the family washes their hands well after using the toilet and changing diapers, and before preparing or eating food.  Wash your baby’s or toddler’s hands often to prevent them from spreading germs to people or objects around the home.

What can I do to keep my child comfortable?

Diarrhea can cause the skin to become very sore. A diaper rash can develop. See the education sheet, “Diaper rash” for instructions on preventing and treating it.

Using extra-absorbent diapers with snug (but not too tight) leg bands, plastic pants, or cloth diapers inside disposable diapers may cut down on some of the clean-up. These methods help with the mess, but may make it hard to know when there is stool against the skin. Be sure to change diapers more often than usual.

Encourage older children to clean themselves well after every stool. You may need to help them more than usual while diarrhea is present.  Rinsing with a squirt bottle of warm water and patting dry may decrease discomfort and improve cleaning.

When should I call the clinic?

Call the clinic if:

• diarrhea becomes worse or does not improve after 48 hours
• diarrhea is watery and vomiting occurs more than 4 times
• blood, mucus, or pus appears in the diarrhea
• severe stomach cramps
• a few loose or mushy stools per day for longer than 2 weeks
• a baby younger than 2 months has a fever above 100.5° F rectally
• an older infant or child has a fever above 104° F
• dizziness when standing up
• if any signs of dehydration, call the clinic right away

Questions?

This is not specific to your child, but provides general information.  If you have any questions, please call the clinic.

Last reviewed 7/2018

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